This assignment will outline the public health issues regarding childhood obesity, the term obesity is when a person is overweight and has a lot of body fat, it is caused by consuming lots of calories, particularly those in fatty and sugary foods, and then have not been burnt off during physical activity. Obesity is a common problem that affects approximately 1 in 5 children aged 10-11. (NHS, 2016).
This essay will outline the effects of obesity and how it affects the body, it will also include how obesity relates to public health, wellbeing, and disability. The essay will explore current health inequalities from a local and national prospective and how these may impact on children or young people with the condition. Towards the end of the essay, it will reflect the public health role of a nurse with regards to improving health, wellbeing, safeguarding, and disability. The determinants of health that will be covered in this assignment will be concentrating on the family’s financial circumstances.
“Public health is defined as the art and science of preventing disease prolonging life and promoting health through organised efforts of society”. (Acheson, 1988). Public Health England is a strategy from The World Health Organisation Europe to strengthen public health capacities and services and aim to provide conditions under which people can maintain a healthy lifestyle, improve their health and wellbeing, or prevent the deterioration of their health. Public health focuses on the entire spectrum of health and wellbeing, not only the eradication of particular diseases. Public Health has been described by the Royal Collage of Nursing (2019) as organised measures to prevent disease promote health and prolong life of the public in private and public sectors, this is identified as the three P’s. Childhood obesity is a rising concern for the government. In England today a third of children aged 2-15 are at risk of are overweight. Obesity is a condition where an individual is carrying excess body fat and has a high body mass index. Increased risks such as diabetes, cardiovascular disease, and other common conditions are associated with being overweight. This is a growing public health concern as the risk of mortality at a younger age is associated as a higher outcome. (GOV.UK, 2017)
Wellbeing is defined as when a person is comfortable, healthy, and happy and they understand how people feel and function on a personal and social level. (Foundation, 2015) Wellbeing relates to childhood obesity because due to them being obese children may experience continuous anxiety, depression, and isolate themselves which is unhealthy for their mental health. (England, 2015) It can also lead to children missing school due to them getting bullied because of their weight, which can result in low self-esteem. Nowadays there is a big stigma around calling children “fat” which can also lead to children getting bullied and miss school because of it.
The Equality Act 2010 defines disability as a physical and mental impairment that has a substantial and long-term adverse effect on a person ability to carry out normal day to day activities. (Sheffield, 2018)
There is a higher risk of obesity among children and young people with disabilities, this can be related to personal factors, for example genetic or metabolic conditions, diet, the amount of physical activity they are able to partake in or the use of medications that have side-effect. Common drugs used in childhood are steroids, insulin, and certain types of antiepileptic drugs. Environmental influences including geographical location and accessibility can have negative effects for accessing health services and recreational facilities. Local and Educational programs run by authorities can also be important factor in this connection. There are other conditions that can play a huge part in childhood obesity, one such as Prader Will Syndrome which can give a predisposition to overeat, the child never feels full. In addition, children with autism may only eat a limited range of foods due to the dislike of flavours, textures an even colour, not having a healthy balanced diet can lead to lots of other health problems not just obesity. (England, 2017)
Health determinants are defined as the social, economic, and environmental factors that shape and influence health factors. (Marmot, 2003) There are so many factors that cause health determinants such as age, education, healthcare services, social class, employment status, housing, and water sanitation. Marmot (2010) has specified that lower social classes are at a higher risk of ill-health and mortality at a younger age, than the higher social classes. (Marmot, 2010)
By reducing the health inequalities stated above means it allows everybody to access the same opportunities so that everyone can lead a healthy lifestyle no matter who they may be or where they may live. Statistics show that people living in areas that are least deprived live 20 years longer than those in deprived areas. These statistics mean more attention is needed to those that live in the deprived areas, tackling the inequalities of poor health, in order to make an impact to change the future. It is paramount to reduce health inequalities in early years of life, by ensuring children get the best start in life means there is a greater chance of reducing health inequalities, improving health, and giving them a brighter future. (Ann Marie Connolly, 2017)
One of the main health determinants causing childhood obesity is the parent’s income. There is a lot of evidence to show that lower income families (single parents, families with one working parent, or no working parents) are at a higher risk of developing obesity, this is because parents that are on a low income do not get the same opportunities/services as opposed to those in a higher socio-economic group. Parents that are on a low income can result in children getting low quality food as it is more cost effective for the family to be able to sustain the daily living costs. This will then intern cause the children further problems, such as the obesity that leads to isolation from other peers, as well as health concerns such as diabetes, tooth decay, and asthma. Also, by the child eating processed cheap foods means the body won’t gain the right nutrients for appropriate growth including the detriments it can have on a child’s learning, as the brain also needs the right food and nutrients in order for it to function properly. (Kozier, 2008) has stated geographical location can become a determinant of bad health, specialist services can be distant from locations, therefore initially costing on travel to be able to access these services. Another influencing factor that could cause a negative effect on a family is the time consumed attending health care services further afield could result in employment conflict from needing longer periods of time off work and schooling.
There are many types of health determinants that contribute and lead to obesity (Public Health England 2014a). This includes 30.7% of men and 34.2% of woman, whom have no qualifications and are labelled as obese, compared to the 19.9% of men and 18.2% of woman who are educated at a degree level. Booth, Charlton and Gulliford (2017) found there is a link between socio-economics status and obesity. They both found there is a direct link between income and obesity. This is different from America, where it shows the occurrence of obesity was only lower in the households with a highest income, proposing that other detriments maybe contributing to obesity. Drewnowski (2009) brought to light the cost difference between food with a higher fat and sugar content and fresh, healthier food with less fat and sugar. Therefore, the households with a lower income and socio-economic status are more inclined to buy cheaper, unhealthy food alternatives. It was discussed by Davis and Chapa (2015) that those with individuals with a poorer education are more likely to be unemployed or employed in a lower payed job, this can then lead to them living in disadvantaged areas, which may have limited access to public physical activity facilities, fewer shops where they can purchase healthier food or pay the costs that would incur with gym memberships. Therefore, having a greater education and more informed choices may help with the growing pandemic of obesity. (Upton, 2017)
According to the 2010-2015 Government obesity and health eating policy most people in England are overweight or obese, 61.9% are adults and 28% are children aged between 2-15 years. It currently costs the NHS over £5 billion a year when dealing with health problems linked with patients being overweight or obese. By 2020, the government and the NHS want to see a decline in obesity in the adult population, as well as a decrease in excess weight in children.
To help with the decline in obesity and prompting healthier choices the government has brought in useful guides to help with this, such as Change4Life. This encourages change and promotes a healthy life style including exercise and change of diet while also educating parents and children on healthier meals and drinks together. The government have also improved the information and labelling system on foods and drinks which allows individuals to understand what’s in the food and make healthier choices. The government are also encouraging restaurants to include calorie information on their food menus to encourage diners to again make a healthier choice. These can all be made through the public health responsibility deal, businesses and organisations are on board to make it easier for everyone to make healthier choices. The Responsibility Deal has four areas (alcohol, food, health at work, and physical activity) which all businesses are encouraged to sign up to, these actions encourage staff and customers alike to make healthier choices for them and their families. These actions include:
- Sugar Tax has been brought in to reduce sugar in soft drinks in order to tackle childhood obesity.
- Reducing harmful ingredients like salt and fat that aren’t good for the body if consumed too much.
- The 5 A DAY encouraging people to eat more fruit and vegetables.
- Calorie information on menus and all food products purchased in stores.
- The school fruit and veg scheme which helps children to meet the target of 5 A DAY.
- There are also the UK activity physical guidelines, this ensures children from a baby right the way up to adult hood are given the right guidance to stay active and healthy.
It is the local council’s responsibility to work with organisations in the area to help improve the health of people living in the area. This is by ensuring the right services are in place. Local councils are given a budget explicitly for public health. This then ensures the health needs of the local community are met. They may put their own plans together to help people who are overweight/obese by gaining advice and help of other organisations.
All healthcare professionals have a responsibility to promote public health. (RCN, 2016) It is highlighted by the NMC that all nurses should encourage health and avert illness. The NMC have specialist community public health nurses (SCPHN), they would have undertaken 10 recognised public health courses that were NMC approved in order for them to work in the public health roles. Such as health visitors, school nurses, occupational health nurses, and family nurses. (NMC, 2019)
The school nurses play a crucial role in helping tackling childhood obesity. Children who are overweight or obese are assigned to weight management programmes, (NICE) national institute for health and care excellence set guidelines to help tackle the issues. The healthcare professionals should encourage the whole family to get on board with the programme it’s ‘positive reinforcement’ and helps the rest of the family stay fit and healthy too. (RCNi, 2015)
All Our Health Framework (2018) was developed by the government to support healthcare professionals, it’s used to maximise the influence nurses can have on improving health and reducing health inequalities. It is paramount that parents understand the importance of healthy exercise and keeping active because a child will learn by watching what is going on around them. If a parent is feeding the family unhealthy foods then the child will know no different, but if a child is fed a well-balanced diet, the right amount of fruit and vegetables, and protein than it’s a good start to the child’s life. It is all part of the 8 stages of the psycho-social development, these stages start from birth and will shape a child as they grow.
- Ann Marie Connolly, A. B. a. C. F., 2017. Health Inequalities, Health Profile England. [Online]
- Available at: https://publichealthmatters.blog.gov.uk/2017/07/13/understanding-health-inequalities-in-england/ [Accessed 18 December 2018].
- England, P. H., 2015. Childhood Obesity: Applying all our health. [Online]
- Available at: https://www.gov.uk/government/publications/childhood-obesity-applying-all-our-health/childhood-obesity-applying-all-our-health [Accessed 15 December 2018].
- England, P. H., 2017. Obesity and disability Children and young people. [Online]
- Available at: https://webarchive.nationalarchives.gov.uk/20170110165944/https://www.noo.org.uk/NOO_pub/briefing_papers [Accessed 15 December 2018].
- Foundation, M. H., 2015. What is wellbeing, how can we measure it and how can we support people to improve it?. [Online]
- Available at: https://www.mentalhealth.org.uk/blog/what-wellbeing-how-can-we-measure-it-and-how-can-we-support-people-improve-it [Accessed 15 December 2018].
- GOV.UK, 2017. Childhood obesity: a plan for action. [Online]
- Available at: https://www.gov.uk/government/publications/childhood-obesity-a-plan-for-action/childhood-obesity-a-plan-for-action [Accessed 15 December 2018].
- Marmot, M., 2010. Fair Society, Health Lives, s.l.: The Marmot Review.
- Marmot, M., 2010. Fair Society, Healthy Lives. The Marmout Review, p. 3.
- Marmot, R. W. a. M., 2003. Social Determinants of Health, The Solid Facts. Second Edition ed. Denmark: World Health Organisation.
- NHS, 2016. Obesity. [Online]
- Available at: https://www.nhs.uk/conditions/obesity/ [Accessed 12 December 2018].
- NMC, N. a. M. C., 2019. SCPHN Registration. [Online]
- Available at: https://www.nmc.org.uk/registration/staying-on-the-register/scphn-registration/ [Accessed 2 January 2019].
- Sheffield, T. U. o., 2018. Disability Confident. [Online]
- Available at: https://www.sheffield.ac.uk/hr/equality/2.5336/definition [Accessed 15 Decamber 2018].
- Upton, J., 2017. Obesity and the nurse's role: reducing health inequalities through health promotion. Links to Health and Social Care, Volume volume 2, p. 41.